Provider Demographics
NPI:1043018757
Name:BERG, MEGAN (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:BERG
Suffix:
Gender:
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5184 DEER CREST DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE FLOCK
Mailing Address - State:AR
Mailing Address - Zip Code:72756-7618
Mailing Address - Country:US
Mailing Address - Phone:479-270-0031
Mailing Address - Fax:
Practice Address - Street 1:724 DEAVER ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-5356
Practice Address - Country:US
Practice Address - Phone:479-259-2339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR4058225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist